Antral follicle count over 35 – a clinic answers your questions

What’s a normal antral follicle count at 35?

If you’re over 35 and feeling overwhelmed by fertility planning, you’re not alone. Understanding your fertility starts with a few key factors, and the more you deep dive, you’re bound to read up on antral follicle count (AFC).

To help you navigate this crucial stage, we’ve partnered with leading Madrid-based fertility clinic Clínica Tambre, to answer your most pressing questions about average antral follicle count by age, or wherever you’re at in the journey.

With over 45 years of expertise and some of the highest success rates in Spain and across Europe, Clínica Tambre is dedicated to providing world-class, patient-centered care. Their state-of-the-art facilities and cutting-edge technology support women exploring fertility treatments and egg donation options.

Connect with their exceptional team for expert guidance and world-leading compassionate care.

Q&A: Understanding antral follicle count at age 35

What are antral follicles?

Antral follicles are tiny, fluid-filled sacs in your ovaries, each holding an immature egg. As we get older, especially after age 35, the number and quality of our eggs naturally decline. That’s where an antral follicle count (AFC) comes in. It’s a key way to understand your ovarian reserve, or how many eggs you’ve got left.

At a certain point in their development, these follicles become more responsive to follicle-stimulating hormone (FSH) the hormone that helps eggs grow. Usually, just one of these follicles makes it all the way to maturity each cycle, releasing an egg when you ovulate.

How to measure antral follicle count

The most accurate way to measure antral follicle count (AFC) is through a vaginal ultrasound. During this procedure, a small probe is inserted into the vagina to view the ovaries from different angles. Antral follicles appear as small black circles on the screen, and the number in each ovary is counted.

This information helps you and your clinic understand your egg development potential and tailor fertility treatments accordingly, including options like egg donation.

Normal antral follicle count by age

While it’s well known that female fertility declines with age, it’s also important to understand that antral follicle count naturally decreases over time. Here’s a general guide to what’s considered a normal, low or high antral follicle count by age group:

• Ages 25 to 34:
  A normal AFC is around 15.
  • Less than 5 is considered low.
  • More than 15 is considered high.
• Ages 35 to 40:
  A normal AFC is around 9.
  • Less than 3 is considered low.
  • More than 12 is considered high.
• Ages 41 to 46:
  As women approach menopause, fertility declines significantly. A normal AFC is around 4.
  • Less than 3 is considered low.
  • More than 10 is considered high.

It’s important to note that AFC can vary month to month and is typically measured during the early follicular phase of your menstrual cycle. Discussing your results with your doctor is the best way to understand what they mean for your fertility and next steps.

What is a good antral follicle count for IVF?

During an IVF cycle, your ovaries are stimulated to mature multiple follicles at once. The higher your antral follicle count, the more eggs your clinic can expect to retrieve.

If you’re over 35 and have a low AFC, you may need higher doses of stimulation medication, and frustratingly – there’s a greater chance your cycle could be cancelled.

While it varies from person to person, Clínica Tambre notes that an antral follicle count between 10 and 15 is typically considered a positive indicator for IVF success.

Can you increase antral follicle count?

Your antral follicle count reflects the number of tiny follicles your ovaries naturally have, and this number is mostly set by age and genetics. While you can’t directly increase the count, you can support your ovarian health through good nutrition, sleep, stress management, and targeted supplementation, working with an expert practitioner.

Fertility treatment may also help your ovaries respond better, even if the follicle count itself doesn’t change. And remember, it’s possible for your AFC to vary, depending on where you’re at in your cycle.

What does it mean if my antral follicle count is lower than average for my age?

A lower-than-average antral follicle count (AFC) for your age can suggest a reduced ovarian reserve. And while that might feel worrying, it absolutely doesn’t mean you’re infertile, or that pregnancy is out of reach. Fertility is complex, and many factors beyond egg count – including egg quality, hormone levels, uterine health and overall wellbeing – play a role in conception.

I have a lower antral follicle count – what are my next steps?

There’s currently no guaranteed way to increase your antral follicle count. But there are lifestyle and nutrition shifts that can support your overall fertility. These include:

• Avoiding smoking and limiting alcohol
• Eating a balanced, nutrient-rich diet (think: plenty of fruit, veg, healthy fats, and whole foods)
• Staying active, in a way that works for your energy and schedule

Beyond lifestyle changes, speaking with a fertility specialist is key. The team at Clínica Tambre takes a compassionate, personalised approach, looking at your full fertility picture – not just a single data point – and exploring every option to support your path to pregnancy.

When could egg donation play a role in treatment?

Opting for donor eggs is a highly personal decision, and there’s no one-size-fits-all. But if you’re over 35 and facing a low ovarian reserve, IVF with donor eggs can significantly increase your chances of a successful pregnancy.

Clínica Tambre provides an inclusive donor egg programme, coordinated by an experienced team who will guide you through every stage, from decision-making to treatment.

What can I do right now?

The first step is a conversation. At Clínica Tambre, the team approach is to listen, taking the time to understand your history, needs, and goals.

If you’re already in treatment and considering transferring your care, Tambre makes the process smooth, supportive, and stress-free.

Connect with Clínica Tambre today for a truly patient-first fertility experience in Spain.